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Rakitzi S, Georgila P, Becker-Woitag AP. The Recovery Process for Individuals With Schizophrenia in the Context of Evidence-Based Psychotherapy and Rehabilitation. EUROPEAN PSYCHOLOGIST 2021. [DOI: 10.1027/1016-9040/a000400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. This systematic review aimed to evaluate the efficacy of Cognitive Behavioral Therapy (CBT), META Cognitive Therapy (MCT), Metacognitive Training (MCTR), Metacognitive Reflection and Insight Therapy (MERIT), of various rehabilitation programs and of recovery programs in schizophrenia. Medline/Pubmed was searched for studies published in English from January 2010 to August 2018, which were screened against inclusion criteria by two reviewers. The methodological quality of the included studies was evaluated by two independent raters, which are the Effective Public Health Practice Project (EPHPP) quality assessment tool for quantitative studies and the fidelity criteria. The study included 41 RCTs and 12 case studies with n = 3,059 persons with schizophrenia. Cognitive Behavioral Therapy (CBT) proved to be superior in terms of the improvement of primary and secondary outcomes. MCT decreased positive symptoms and improved metacognitive capacity and insight. MCTR reduced positive symptoms and socially disruptive behavior. MERIT improved metacognitive capacity and insight. Rehabilitation programs were efficacious in the improvement of cognition, symptoms, and functional outcome. The recovery programs enhanced illness-management knowledge, attitudes toward medication and insights related to negative symptoms. It is recommended to combine the above evidence based psychotherapeutic interventions. Limitations of this systematic review are discussed toward the end of the essay. Some important factors have to be considered in the future have been mentioned.
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Affiliation(s)
| | - Polyxeni Georgila
- Psychiatric Department for Adults, General Hospital G. Gennimatas, Athens, Greece
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Vicent-Gil M, Raventós B, Marín-Martínez ED, González-Simarro S, Martínez-Arán A, Bonnin CDM, Trujols J, Pérez-Blanco J, de Diego-Adeliño J, Puigdemont D, Serra-Blasco M, Cardoner N, Portella MJ. Testing the efficacy of INtegral Cognitive REMediation (INCREM) in major depressive disorder: study protocol for a randomized clinical trial. BMC Psychiatry 2019; 19:135. [PMID: 31060604 PMCID: PMC6501398 DOI: 10.1186/s12888-019-2117-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 04/12/2019] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Given the limitation of pharmacological treatments to treat cognitive symptoms in patients with Major Depressive Disorder (MDD), cognitive remediation programs has been proposed as a possible procognitive intervention but findings are not conclusive. This study investigates the efficacy of an INtegral Cognitive REMediation (INCREM) that includes a combination of a Functional Remediation (FR) strategy plus a Computerized Cognitive Training (CCT) in order to improve not only cognitive performance but also the psychosocial functioning and the quality of life. METHODS A single blind randomized controlled clinical trial in 81 patients with a diagnosis of MDD in clinical remission or in partial remission. Participants will be randomized to one of three conditions: INCREM (FR + CCT), Psychoeducation plus online games and Treatment As Usual (TAU). Intervention will consist in 12 group sessions, of approximately 110 min once a week. The primary outcome measure will be % of change in psychosocial functioning after treatment measured by the Functional Assessment Short Test (FAST); additionally, number of sick leaves and daily activities will also be recorded as pragmatic outcomes. DISCUSSION To our knowledge, this is the first randomized controlled clinical trial using a combination of two different approaches (FR + CCT) to treat the present cognitive deficits and to promote their improvements into a better psychosocial functioning. TRIAL REGISTRATION Clinical Trials NCT03624621 . Date registered 10th of August 2018 and last updated 24th August 2018.
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Affiliation(s)
- Muriel Vicent-Gil
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Institut d’Investigació Biomèdica Sant Pau (IBB-Sant Pau), Universitat Autònoma de Barcelona (UAB), Sant Antoni Ma Claret 167, 08025 Barcelona, Catalonia Spain
- Mental Health Unit, Hospital Universitari Parc Taulí, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Institut d’Investigació i Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona (UAB), Sabadell, Barcelona, Catalonia Spain
| | - Beatriz Raventós
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Institut d’Investigació Biomèdica Sant Pau (IBB-Sant Pau), Universitat Autònoma de Barcelona (UAB), Sant Antoni Ma Claret 167, 08025 Barcelona, Catalonia Spain
| | - Eduardo D. Marín-Martínez
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Institut d’Investigació Biomèdica Sant Pau (IBB-Sant Pau), Universitat Autònoma de Barcelona (UAB), Sant Antoni Ma Claret 167, 08025 Barcelona, Catalonia Spain
| | - Sara González-Simarro
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Institut d’Investigació Biomèdica Sant Pau (IBB-Sant Pau), Universitat Autònoma de Barcelona (UAB), Sant Antoni Ma Claret 167, 08025 Barcelona, Catalonia Spain
| | - Anabel Martínez-Arán
- Bipolar and Depressive Disorders Unit, Institute of Neurosciences, Hospital Clínic de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), IDIBAPS, University of Barcelona (UB), Barcelona, Catalonia Spain
| | - Caterina del Mar Bonnin
- Bipolar and Depressive Disorders Unit, Institute of Neurosciences, Hospital Clínic de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), IDIBAPS, University of Barcelona (UB), Barcelona, Catalonia Spain
| | - Joan Trujols
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Institut d’Investigació Biomèdica Sant Pau (IBB-Sant Pau), Universitat Autònoma de Barcelona (UAB), Sant Antoni Ma Claret 167, 08025 Barcelona, Catalonia Spain
| | - Josefina Pérez-Blanco
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Institut d’Investigació Biomèdica Sant Pau (IBB-Sant Pau), Universitat Autònoma de Barcelona (UAB), Sant Antoni Ma Claret 167, 08025 Barcelona, Catalonia Spain
| | - Javier de Diego-Adeliño
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Institut d’Investigació Biomèdica Sant Pau (IBB-Sant Pau), Universitat Autònoma de Barcelona (UAB), Sant Antoni Ma Claret 167, 08025 Barcelona, Catalonia Spain
| | - Dolors Puigdemont
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Institut d’Investigació Biomèdica Sant Pau (IBB-Sant Pau), Universitat Autònoma de Barcelona (UAB), Sant Antoni Ma Claret 167, 08025 Barcelona, Catalonia Spain
| | - Maria Serra-Blasco
- Mental Health Unit, Hospital Universitari Parc Taulí, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Institut d’Investigació i Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona (UAB), Sabadell, Barcelona, Catalonia Spain
| | - Narcís Cardoner
- Mental Health Unit, Hospital Universitari Parc Taulí, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Institut d’Investigació i Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona (UAB), Sabadell, Barcelona, Catalonia Spain
| | - Maria J. Portella
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Institut d’Investigació Biomèdica Sant Pau (IBB-Sant Pau), Universitat Autònoma de Barcelona (UAB), Sant Antoni Ma Claret 167, 08025 Barcelona, Catalonia Spain
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Amoretti S, Cabrera B, Torrent C, Bonnín CDM, Mezquida G, Garriga M, Jiménez E, Martínez-Arán A, Solé B, Reinares M, Varo C, Penadés R, Grande I, Salagre E, Parellada E, Bioque M, Garcia-Rizo C, Meseguer A, Anmella G, Rosa AR, Contreras F, Safont G, Vieta E, Bernardo M. Cognitive Reserve Assessment Scale in Health (CRASH): Its Validity and Reliability. J Clin Med 2019; 8:E586. [PMID: 31035381 PMCID: PMC6572583 DOI: 10.3390/jcm8050586] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 04/18/2019] [Accepted: 04/25/2019] [Indexed: 02/03/2023] Open
Abstract
(1) Background: The cognitive reserve (CR) concept has not been precisely defined in severe mental disorders and has been estimated using heterogeneous methods. This study aims to investigate and develop the psychometric properties of the Cognitive Reserve Assessment Scale in Health (CRASH), an instrument designed to measure CR in people with severe mental illness; (2) Methods: 100 patients with severe mental illness (non-affective psychoses and affective disorders) and 66 healthy controls were included. The internal consistency and convergent validity of CRASH were assessed. Spearman's correlations coefficients were also performed to examine the relationship between CRASH and neuropsychological tests, psychosocial functioning, and clinical course; (3) Results: The internal consistency was high (Cronbach's alpha coefficient = 0.903). The CRASH global score had a large positive correlation with the Cognitive reserve questionnaire total score (r = 0.838, p < 0.001), demonstrating good convergent validity. The correlation coefficients between the CRASH total scores and clinical, functional, and neuropsychological performance were different between groups. In order to provide clinical interpretation, severity classification based on diagnosis (non-affective psychotic disorders, affective disorders, and healthy controls) have been created; (4) Conclusions: CRASH is the first CR measure developed specifically for patients with severe mental illness, facilitating reliable and valid measurement of this construct. The scale may aid in the stratification of patients and the implementation of personalized interventions.
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Affiliation(s)
- Silvia Amoretti
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, 08036 Barcelona, Spain.
- Biomedical Research Networking Center for Mental Health (CIBERSAM), 28029 Madrid, Spain.
- University of Barcelona, 08036 Barcelona, Spain.
| | - Bibiana Cabrera
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, 08036 Barcelona, Spain.
- Biomedical Research Networking Center for Mental Health (CIBERSAM), 28029 Madrid, Spain.
- University of Barcelona, 08036 Barcelona, Spain.
| | - Carla Torrent
- Biomedical Research Networking Center for Mental Health (CIBERSAM), 28029 Madrid, Spain.
- University of Barcelona, 08036 Barcelona, Spain.
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain.
- Bipolar and Depressive Disorders Unit, Institute of Neurosciences, 08036 Barcelona, Spain.
| | - Caterina Del Mar Bonnín
- Biomedical Research Networking Center for Mental Health (CIBERSAM), 28029 Madrid, Spain.
- University of Barcelona, 08036 Barcelona, Spain.
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain.
- Bipolar and Depressive Disorders Unit, Institute of Neurosciences, 08036 Barcelona, Spain.
| | - Gisela Mezquida
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, 08036 Barcelona, Spain.
- Biomedical Research Networking Center for Mental Health (CIBERSAM), 28029 Madrid, Spain.
- University of Barcelona, 08036 Barcelona, Spain.
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain.
| | - Marina Garriga
- Biomedical Research Networking Center for Mental Health (CIBERSAM), 28029 Madrid, Spain.
- University of Barcelona, 08036 Barcelona, Spain.
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain.
- Bipolar and Depressive Disorders Unit, Institute of Neurosciences, 08036 Barcelona, Spain.
| | - Esther Jiménez
- Biomedical Research Networking Center for Mental Health (CIBERSAM), 28029 Madrid, Spain.
- University of Barcelona, 08036 Barcelona, Spain.
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain.
- Bipolar and Depressive Disorders Unit, Institute of Neurosciences, 08036 Barcelona, Spain.
| | - Anabel Martínez-Arán
- Biomedical Research Networking Center for Mental Health (CIBERSAM), 28029 Madrid, Spain.
- University of Barcelona, 08036 Barcelona, Spain.
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain.
- Bipolar and Depressive Disorders Unit, Institute of Neurosciences, 08036 Barcelona, Spain.
| | - Brisa Solé
- Biomedical Research Networking Center for Mental Health (CIBERSAM), 28029 Madrid, Spain.
- University of Barcelona, 08036 Barcelona, Spain.
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain.
- Bipolar and Depressive Disorders Unit, Institute of Neurosciences, 08036 Barcelona, Spain.
| | - Maria Reinares
- Biomedical Research Networking Center for Mental Health (CIBERSAM), 28029 Madrid, Spain.
- University of Barcelona, 08036 Barcelona, Spain.
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain.
- Bipolar and Depressive Disorders Unit, Institute of Neurosciences, 08036 Barcelona, Spain.
| | - Cristina Varo
- Biomedical Research Networking Center for Mental Health (CIBERSAM), 28029 Madrid, Spain.
- University of Barcelona, 08036 Barcelona, Spain.
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain.
- Bipolar and Depressive Disorders Unit, Institute of Neurosciences, 08036 Barcelona, Spain.
| | - Rafael Penadés
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, 08036 Barcelona, Spain.
- Biomedical Research Networking Center for Mental Health (CIBERSAM), 28029 Madrid, Spain.
- University of Barcelona, 08036 Barcelona, Spain.
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain.
| | - Iria Grande
- Biomedical Research Networking Center for Mental Health (CIBERSAM), 28029 Madrid, Spain.
- University of Barcelona, 08036 Barcelona, Spain.
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain.
- Bipolar and Depressive Disorders Unit, Institute of Neurosciences, 08036 Barcelona, Spain.
| | - Estela Salagre
- Biomedical Research Networking Center for Mental Health (CIBERSAM), 28029 Madrid, Spain.
- University of Barcelona, 08036 Barcelona, Spain.
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain.
- Bipolar and Depressive Disorders Unit, Institute of Neurosciences, 08036 Barcelona, Spain.
| | - Eduard Parellada
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, 08036 Barcelona, Spain.
- Biomedical Research Networking Center for Mental Health (CIBERSAM), 28029 Madrid, Spain.
- University of Barcelona, 08036 Barcelona, Spain.
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain.
| | - Miquel Bioque
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, 08036 Barcelona, Spain.
- Biomedical Research Networking Center for Mental Health (CIBERSAM), 28029 Madrid, Spain.
- University of Barcelona, 08036 Barcelona, Spain.
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain.
| | - Clemente Garcia-Rizo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, 08036 Barcelona, Spain.
- Biomedical Research Networking Center for Mental Health (CIBERSAM), 28029 Madrid, Spain.
- University of Barcelona, 08036 Barcelona, Spain.
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain.
| | - Ana Meseguer
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, 08036 Barcelona, Spain.
- Biomedical Research Networking Center for Mental Health (CIBERSAM), 28029 Madrid, Spain.
| | - Gerard Anmella
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, 08036 Barcelona, Spain.
- University of Barcelona, 08036 Barcelona, Spain.
- Bipolar and Depressive Disorders Unit, Institute of Neurosciences, 08036 Barcelona, Spain.
| | - Adriane R Rosa
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-003, Brazil.
- Postgraduate Program: Psychiatry and Behavioral Science, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 90040-060, Brazil.
- Department of Pharmacology and Postgraduate Program: Pharmacology and Therapeutics, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 90040-060, Brazil.
| | - Fernando Contreras
- Biomedical Research Networking Center for Mental Health (CIBERSAM), 28029 Madrid, Spain.
- Psychiatry Department, Bellvitge University Hospital-IDIBELL, 08907 L'Hospitalet de Llobregat, Spain.
| | - Gemma Safont
- Biomedical Research Networking Center for Mental Health (CIBERSAM), 28029 Madrid, Spain.
- University of Barcelona, 08036 Barcelona, Spain.
- Hospital Universitari Mutua Terrassa, 08221 Terrassa, Spain.
| | - Eduard Vieta
- Biomedical Research Networking Center for Mental Health (CIBERSAM), 28029 Madrid, Spain.
- University of Barcelona, 08036 Barcelona, Spain.
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain.
- Bipolar and Depressive Disorders Unit, Institute of Neurosciences, 08036 Barcelona, Spain.
| | - Miquel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, 08036 Barcelona, Spain.
- Biomedical Research Networking Center for Mental Health (CIBERSAM), 28029 Madrid, Spain.
- University of Barcelona, 08036 Barcelona, Spain.
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain.
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Neurocognitive and Self-efficacy Benefits of Cognitive Remediation in Schizophrenia: A Randomized Controlled Trial. J Int Neuropsychol Soc 2018; 24:549-562. [PMID: 29352823 DOI: 10.1017/s1355617717001369] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate the impact of computer-assisted "drill-and-strategy" cognitive remediation (CR) for community-dwelling individuals with schizophrenia on cognition, everyday self-efficacy, and independent living skills. METHODS Fifty-six people with schizophrenia or schizoaffective disorder were randomized into CR or computer game (CG) playing (control), and offered twenty 1-hr individual sessions in a group setting over 10 weeks. Measures of cognition, psychopathology, self-efficacy, quality of life, and independent living skills were conducted at baseline, end-group and 3 months following intervention completion. RESULTS Forty-three participants completed at least 10 sessions and the end-group assessment. Linear mixed-effect analyses among completers demonstrated a significant interaction effect for global cognition favoring CR (p=.028). CR-related cognitive improvement was sustained at 3-months follow-up. At end-group, 17 (77%) CR completers showed a reliable improvement in at least one cognitive domain. A significant time effect was evident for self-efficacy (p=.028) with both groups improving over time, but no significant interaction effect was observed. No significant effects were found for other study outcomes, including the functional measure. CONCLUSIONS Computer-assisted drill-and-strategy CR in schizophrenia improved cognitive test performance, while participation in both CR and CG playing promoted enhancements in everyday self-efficacy. Changes in independent living skills did not appear to result from CR, however. Adjunctive psychosocial rehabilitation is likely necessary for improvements in real-world community functioning to be achieved. (JINS, 2018, 24, 549-562).
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Lanfredi M, Deste G, Ferrari C, Barlati S, Magni LR, Rossi R, de Peri L, Bonomi M, Rossi G, Vita A. Effects of cognitive remediation therapy on neurocognition and negative symptoms in schizophrenia: an Italian naturalistic study. Cogn Neuropsychiatry 2017; 22:53-68. [PMID: 27921860 DOI: 10.1080/13546805.2016.1260537] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Cognitive remediation therapy (CRT) has been reported to positively affect neurocognitive processes among patients with schizophrenia; however, the degree to which changes in cognition is linked to improved clinical symptoms, remains poorly understood. The current study aimed to investigate whether cognitive gains were associated to improvements in negative symptoms' severity in patients with schizophrenia living in two Italian psychiatric facilities. METHODS Patients with a diagnosis of schizophrenia were consecutively assigned to CRT (n = 33) and compared with an historical control group (n = 28). Assessments were performed at baseline and post-treatment using a neuropsychological battery (Trail Making Test A and B, Self-Ordered Pointing Task, California Verbal Learning Test), along with clinical and functioning measures. RESULTS Visual attention (TMT-A score change) was found as the only significant predictor of improvement in negative symptoms subscale of the Positive and Negative Syndrome Scale. Furthermore, a mediation path analysis confirmed that better performance in visual attention acts as mediator of the positive association between CRT intervention and lower post-treatment negative symptoms score. CONCLUSIONS CRT can have a positive impact on a measure of visual attention in patients with schizophrenia and on negative symptoms reduction that is mediated by this significant intervention effect.
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Affiliation(s)
- Mariangela Lanfredi
- a Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli , Brescia , Italy
| | - Giacomo Deste
- b Department of Psychiatry , Spedali Civili Hospital , Brescia , Italy
| | - Clarissa Ferrari
- c cService of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli , Brescia , Italy
| | - Stefano Barlati
- b Department of Psychiatry , Spedali Civili Hospital , Brescia , Italy
| | - Laura Rosa Magni
- a Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli , Brescia , Italy
| | - Roberta Rossi
- a Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli , Brescia , Italy
| | - Luca de Peri
- b Department of Psychiatry , Spedali Civili Hospital , Brescia , Italy
| | - Marco Bonomi
- b Department of Psychiatry , Spedali Civili Hospital , Brescia , Italy
| | - Giuseppe Rossi
- a Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli , Brescia , Italy
| | - Antonio Vita
- b Department of Psychiatry , Spedali Civili Hospital , Brescia , Italy
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Pascual JC, Palomares N, Ibáñez Á, Portella MJ, Arza R, Reyes R, Feliu-Soler A, Díaz-Marsá M, Saiz-Ruiz J, Soler J, Carrasco JL. Efficacy of cognitive rehabilitation on psychosocial functioning in Borderline Personality Disorder: a randomized controlled trial. BMC Psychiatry 2015; 15:255. [PMID: 26487284 PMCID: PMC4617906 DOI: 10.1186/s12888-015-0640-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 10/07/2015] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Follow-up studies revealed that subjects with borderline personality disorder (BPD) present high rates of clinical remission, although psychosocial functioning often remains impaired. The aim of this study is to evaluate the efficacy of a cognitive rehabilitation intervention versus a psychoeducational program on psychosocial functioning in subjects with BPD. METHODS A multicenter, randomized, and positive-controlled clinical trial was conducted. Seventy outpatients with BPD were randomized to cognitive rehabilitation or psychoeducational group interventions. Participants were evaluated after completion of the intervention period (16 weeks) and after the follow-up period (6 months). Psychosocial functioning, clinical and neuropsychological outcomes were evaluated. RESULTS No main effects of group or group x time were observed on functionality but a significant effect of time was found. Post-hoc analyses showed that only cognitive rehabilitation increased psychosocial functioning significantly at endpoint. Psychoeducation showed a significant enhancement of depressive symptoms. CONCLUSIONS Cognitive rehabilitation and psychoeducational interventions appeared to show good efficacy in improving disabilities in daily life in subjects with BPD. These interventions are easily implemented in mental health settings and have the advantage of improving general functioning and clinical symptoms. TRIAL REGISTRATION Clinicaltrials.gov: NCT02033044. Registered 9 January 2014.
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Affiliation(s)
- Juan C. Pascual
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain ,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Institut d’Investigació Biomèdica - Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, Av. Sant Antoni Ma Claret 167, 08025 Barcelona, Spain
| | - Nerea Palomares
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain. .,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Departamento de Psiquiatría, Universidad Complutense, Madrid, Spain.
| | - Ángela Ibáñez
- Department of Psychiatry, Universitary Hospital Ramón y Cajal, CIBERSAM, IRYCIS, Madrid, Spain. .,Department of Psychiatry, Universidad de Alcalá, Madrid, Spain.
| | - Maria J. Portella
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain ,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Institut d’Investigació Biomèdica - Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, Av. Sant Antoni Ma Claret 167, 08025 Barcelona, Spain
| | - Rocío Arza
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain. .,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Departamento de Psiquiatría, Universidad Complutense, Madrid, Spain.
| | - Raquel Reyes
- FIBio-HRC, Universitary Hospital Ramón y Cajal, Madrid, Spain.
| | - Albert Feliu-Soler
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. .,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Institut d'Investigació Biomèdica - Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, Av. Sant Antoni Ma Claret 167, 08025, Barcelona, Spain.
| | - Marina Díaz-Marsá
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain. .,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Departamento de Psiquiatría, Universidad Complutense, Madrid, Spain.
| | - Jerónimo Saiz-Ruiz
- Department of Psychiatry, Universitary Hospital Ramón y Cajal, CIBERSAM, IRYCIS, Madrid, Spain. .,Department of Psychiatry, Universidad de Alcalá, Madrid, Spain.
| | - Joaquim Soler
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. .,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Institut d'Investigació Biomèdica - Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, Av. Sant Antoni Ma Claret 167, 08025, Barcelona, Spain.
| | - Jose L. Carrasco
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain ,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Departamento de Psiquiatría, Universidad Complutense, Madrid, Spain
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